Uterine rupture is the biggest risk, but with careful planning and good care during labor, a rupture is unlikely. A uterus that is not being pushed to contract artificially will generally not work itself until it breaks; it's just not how the body works. The pp mentioned that her labor had stalled, and the window was found when the second c-section was performed. This makes sense- the stalled labor was her body's way of telling everyone that there was something wrong. For this reason, I believe that the safest way to attempt a Vbac is unaugmented and without epidural anesthesia. Since most hospitals have a "constant monitoring of Vbac" policy, there is a higher success rate with Hbacs than Vbacs in hospitals.
keep in mind that the risk of uterine rupture overall for the first Vbac is between .5 and 1.5%, and maybe even lower if labor is not induced or augmented. Even if there is a rupture, although they can be quite serious, most are partial ruptures that require another c-section, but do not harm the mother or the baby. And a c-section is really a (albeit somewhat controlled ) rupture of the uterus. Personally, I would take my chances with the Vbac, especially since c-sections are also far from risk- free. [/U]

Exactly! While uterine rupture is a risk, my mw stated that my chances (as a VBAC) were only .5% more than a normal pregnant women without a previous c/s. My thoughts were I could always have another c/s, but I won't always have the chance to have vaginal births if I don't try right now. Also when it comes to the monitoring, as long as your provider is okay with intermittent monitoring (get it on paper/birth plan SIGNED by your provider) the hospital/nurses should follow it.

Child birth itself can be a dangerous and traumatic event. It was the leading killer of women for many many years, and still is in some places. C/s or vbac both have their risks, and advantages. The best thing you can do is to make yourself informed. Be aware of what can happen, and have someone with you who can keep a clear head and help you make informed decisions while in labor.

During my vbac, I remember thinking "it could all be over in a few minutes and I wouldn't have to worry about rupture if I just said yes to the c/s." My dh read my mind and reminded me of my wishes and kept me strong. My doula had been a l/d nurse for decades, and she kept us informed of what things really meant. Those things got me through it, and I was glad for it.

Uterine rupture is the biggest risk, but with careful planning and good care during labor, a rupture is unlikely. A uterus that is not being pushed to contract artificially will generally not work itself until it breaks; it's just not how the body works. The pp mentioned that her labor had stalled, and the window was found when the second c-section was performed. This makes sense- the stalled labor was her body's way of telling everyone that there was something wrong. For this reason, I believe that the safest way to attempt a Vbac is unaugmented and without epidural anesthesia. Since most hospitals have a "constant monitoring of Vbac" policy, there is a higher success rate with Hbacs than Vbacs in hospitals.
keep in mind that the risk of uterine rupture overall for the first Vbac is between .5 and 1.5%, and maybe even lower if labor is not induced or augmented. Even if there is a rupture, although they can be quite serious, most are partial ruptures that require another c-section, but do not harm the mother or the baby. And a c-section is really a (albeit somewhat controlled ) rupture of the uterus. Personally, I would take my chances with the Vbac, especially since c-sections are also far from risk- free. [/U]

Exactly this! Some OB's won't touch a VBAC due to fear of liability. The risk of VBAC isn't as high as once thought. And c-sections DO have their own risks, something that isn't really talked about by OB's nearly enough, IMO.

There is no reason why you couldn't attempt to VBAC. Your first c-section had nothing to do with the shape of your pelvis or the size of your baby.

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Jenn, happily married to 10/96,
mom to 12/01, and 3/04,
momma again to 1/10, and a new baby 3/13

Just so you know I totally believe my body knew exactly what it was doing when it stalled at 4cm and even though I ended up with another c-section I wouldn't have changed a thing. Going for a VBAC was something of a personal climbing of Mt Everest for me after my first labor a decade ago. My ob knew this and did everything she possibly could to facilitate the process and she was also adamantly against any kind of chemical inducers. Under no circumstances would I be given any form of pitocin and I couldn't agree with her more. FWIW I was allowed an epidural but I held out for that until 4cm and had a really light one with no other opiods so I could still move my legs. There are so many things that my doula helped me with at this point and a bunch of preplanning sessions with my ob that prepped myself for this.
Gather all the info you can, make notes about questions that come up between your office visits.

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Crazy semi-crunchy scientist mama to 1 DD almost 10 yrs old and DD 2 born July '11. CDing, extended vaxing, ERF, even been known to co-sleep (gasp!), and trying my best to baby wear a very persnickety diva.